Thumb joint osteoarthritis

[MissMolly]

I have OA in my basal thumb joint. It's been a problem off and on for years but in the past year started experiencing significant pain/aching/weakness. Due to COVID I resisted going to the doctor. I take ibuprofen and acetaminophen daily. By June the pain/aching was really bad all day. Researched on the internet which suggested a thumb brace. Got one of those and wore it every day/night for months. Didn't seem to help. In October my fingers started going numb. Pain/aching continued so I finally broke down and went to the orthopedic hand doctor in late December.

X-rays show my cartilage is completely worn away. That joint is bone-on-bone. Bone spurs have formed throwing the joint out of alignment so now I have a lump growing on the side of my hand. The doc agreed to give me a steroid shot which has greatly reduced the constant aching but has not helped the pain or numbness. The doc tells me I need joint replacement surgery but he will leave it up to me to decide when I am ready to move forward with that. In the meantime, he is willing to give me steroid shots every 3 months.

My question - has anybody had the LRTI (ligament reconstruction and tendon interposition) surgery for the basal joint and if so can you share your experience with that?

Thanks

 

[whatnot]

I have the same issue. I have gotten 4 steroid shots, 1 shot a year over last 4 years. But not bad enough for surgery.
The last shot is beginning to wear off and pain is returning. It isn’t that bad yet. I use a CBD cream and it helps significantly. I use this cream to delay having to get another steroid shot too soon.
So can’t help with the surgery part of your question, but the CBD cream can alleviate your pain until you have surgery.

 

[MissMolly]

I've tried the CBD cream. It didn't help, but it smells really good - kind of minty. I've found that CBD cream is great for soothing itching like from dry skin or bug bites. I have tried Voltaren gel. Tried Flexor patches. Neither helps. When the pain gets bad I wrap my hand up in the heating pad and turn it on high while watching TV. That helps. Ice makes it hurt worse, so I don't do ice. I've tried just about everything. This shot I got a month ago has been the best help so far. Hopefully it will work for awhile. But reading about these steroid shots....they have their own bad side effects too. And the shot doesn't help with the inability to use my thumb normally. It hurts to do little things - peel potatoes, slice carrots... Can't pick up a heavy pot. Can't open jars (got a battery jar opener for Christmas). Can't twist the pepper mill - got a battery one of those for my birthday in November. So I am finding ways to work around it. This shot has helped so much, but I know it is only temporary and is only masking the problem.

 

[whatnot]

Yes the shot is temporary. Usually, it helps about 8 months and then the pain gets progressively worse. The side effects are the reason I only do it 1x a year.
Good luck with your research on the surgery. I’ll be following this thread.

 

[littleb]

OP

Sorry to hear you have endured so much pain with your OA.

I was diagnosed a few years ago with the same thumb condition when I asked the Dr about a hard lump in my thumb joint. My thumb is disfigured but I have not had as much pain. Only the occasional aching and reduced hand strength and dexterity.

My only suggestion is if you decide on surgery make sure you find a good dr who specializes in hand surgery.

Good luck. I might be in the same boat in the next few years.

 

[Extra Medium]

I work as a physician assistant in hand surgery, and also have early OA of this joint myself. With a skilled (board certified) hand surgeon, the surgery for this generally does very well. I believe in it enough that I advised my dad to get it, and will likely get it myself one day. In the meantime, using injections every once in awhile will do for me. They're pretty low risk, and often effective for months at a time.

Your numbness may be a separate concern, such as carpal tunnel syndrome, and should probably be worked up independent of the osteoarthritis.

 

[MissMolly]

I work as a physician assistant in hand surgery, and also have early OA of this joint myself. With a skilled (board certified) hand surgeon, the surgery for this generally does very well. I believe in it enough that I advised my dad to get it, and will likely get it myself one day. In the meantime, using injections every once in awhile will do for me. They're pretty low risk, and often effective for months at a time.

Your numbness may be a separate concern, such as carpal tunnel syndrome, and should probably be worked up independent of the osteoarthritis.

Well, yes, you are correct about the numbness being a separate concern. I had the nerve conduction test on both arms and was told my responses are "off". The doc says I have moderate to severe carpal tunnel in the problem hand (which could be caused by the arthritis) and mild carpal tunnel in other. But he went on to say that the carpal tunnel is not enough to explain what they are seeing in the nerve test and sent me for an MRI. The MRI shows a problem in my neck, according to the doctor. However, he explained he is a hand specialist not a spine specialist and cannot properly interpret what he is seeing on the MRI. Has set me up with an appointment with the spine specialist for Feb 1. *sigh*

 

[atmsmshr]

I have OA in my big toes, likely from being an avid runner when younger.

Had the surgery on the right foot 10 years ago to scrape back the bone spur. Ow, ow, ow, ow for years on a weight bearing joint.

 

[pacergal]

OP--sounds like you have several different issues going on affecting your strength and pain in your hands, sorry to hear that. Hopefully you will find solutions soon.
I also have OA in most of my finger joints and my neck. Luckily, no shots needed at this point, but the pain and swelling does make opening jars, etc difficult. And when the neck flares up too much, the tingling and numbness is bothersome.
I take daily naproxen and use CBD/THC 50:50 cream, which helps greatly when the pain is bad. I, too, find heat helps much better than cold.
Good health wishes to you and keep looking for answers.

 

[Ronstar]

I have the same issue, but to a lesser extent than OP. Hardly ever have pain, and it's mild when I do. My thumb gets stuff and doesn't have a full range of motion. Operating hand tools is difficult.

I had some therapy and ultrasound treatments to reduce inflammation. It worked for a while and then stiffness came back. Now I just deal with it.

 

[Bob_Walter]

Anyone try PRP injections into the thumb joint?

 

[Cerys]

I have OA in my basal thumb joint. It's been a problem off and on for years but in the past year started experiencing significant pain/aching/weakness. Due to COVID I resisted going to the doctor. I take ibuprofen and acetaminophen daily. By June the pain/aching was really bad all day. Researched on the internet which suggested a thumb brace. Got one of those and wore it every day/night for months. Didn't seem to help. In October my fingers started going numb. Pain/aching continued so I finally broke down and went to the orthopedic hand doctor in late December.

X-rays show my cartilage is completely worn away. That joint is bone-on-bone. Bone spurs have formed throwing the joint out of alignment so now I have a lump growing on the side of my hand. The doc agreed to give me a steroid shot which has greatly reduced the constant aching but has not helped the pain or numbness. The doc tells me I need joint replacement surgery but he will leave it up to me to decide when I am ready to move forward with that. In the meantime, he is willing to give me steroid shots every 3 months.

My question - has anybody had the LRTI (ligament reconstruction and tendon interposition) surgery for the basal joint and if so can you share your experience with that?

Thanks

I had it done several years ago. I have never ever regretted it. Pain is gone. My hand is not as strong as before, but what can you do when you can’t do anything with it anyway. So totally worth it even though it’s 75% of what it used to be maybe 80. I can crochet, do needlework, I can cook... all good and no pain.

My doctor is an excellent surgeon. And he was strict. I had heard about people getting out of their cast in three weeks — no. I was in a cast for six weeks, it was changed once. And then I was in a splint for 24 hours a day I only took it off the shower. And for therapy. And we’re talking three months of therapy at three days a week. The hand exercises were explained completely, they actually watched me do them so I was doing them properly and they were easy enough to do anywhere. I used to do a set of hand exercises while I was waiting at the gas station to get gas.

I took Vicodin for about a week. At first as directed every four hours I was popping a pill. And I needed it because this was major surgery. You also have to keep your hand above your heart for 48 hours I believe. When you don’t, it throbs and hurts like you can’t believe. But once you find a position to lay in and sit in where are you can easily accomplish keeping that hand above your heart it’s very easy to do.

My husband and I also ran a janitorial company, and we did the cleaning. I was off work for about two months I went back how does my husband called it light duty. Basically I vacuumed one floor while he did everything else.

The way he positioned the scar it’s sort of into in the fold of my thumb. I can’t really see it anymore. And the ones on top have disappeared.

 

[MissMolly]

Thank you for your sharing your experience. I have my appointment tomorrow with the spine doctor and then once I have all the information about what is going on with me I will be able to make some decisions about how go forward with all of this.

I know I will eventually need to get the thumb surgery since nothing else will make the arthritis go away or regrow the cushioning that is now missing in that joint. The shot from December is still working to keep the aching down to a manageable level as well as some of the pain in the thumb. The aching is worse in the morning but ever present throughout the day, but manageable. The numbness in my fingers has not been relieved at all and is really a problem. Between not being able to pinch well with that hand and the numbness, it's almost impossible to pick up some things. Typing is very difficult to do since I can't feel the keys so I have to keep my eyes on my fingers.

Due to the recovery time for the thumb surgery I am hoping to put that off until next December. I like to garden and work outside and would be unable to do that if I have surgery now. But then again, due to everything I may find I can't do it anyway. Don't know. And I am hoping the finger numbness is due to carpal tunnel and not something in my neck. I really, really don't want another neck surgery. If it's carpal tunnel, then I would think both the thumb and the carpal tunnel could be addressed at the same time. But then the thought of continuing to spend another year like this is depressing. Plus I don't know if there is any kind of permanent damage to my nerves if I delay this.

But it's nice to know you don't regret it. I have read it's a painful surgery and you seem to agree with that. *sigh* I haven't crocheted in years, but I cannot imagine trying to do that right now. Those little tiny movements would be so painful and not feeling the yarn...oy vey! I'm glad you are better even though not 100%. That's encouraging.

ETA: My hand doctor was one of the lead doctors on the team that did the first two human hand transplants, so I'm guessing he has some good experience with hand surgery.